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Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy
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Observations on real-time prostate gland motion using electromagnetic tracking.

Katja M Langen1, Twyla R Willoughby, Sanford L Meeks

  • 1Department of Radiation Oncology, M. D. Anderson Cancer Center Orlando, Orlando, FL 32806, USA. katja.langen@orhs.org

International Journal of Radiation Oncology, Biology, Physics
|February 19, 2008
PubMed
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Prostate gland movement during radiotherapy averaged 14% displacement over 3 mm and 3% over 5 mm. Real-time tracking revealed increasing prostate displacement over time after positioning, emphasizing prompt treatment initiation.

Area of Science:

  • Radiation oncology
  • Medical physics
  • Biomedical engineering

Background:

  • Accurate radiotherapy requires precise tumor targeting.
  • Prostate gland motion during treatment can lead to inaccurate radiation delivery.
  • Real-time monitoring systems are crucial for assessing and managing intra-fraction motion.

Purpose of the Study:

  • To quantify and describe the real-time movement of the prostate gland in a large patient cohort undergoing radiotherapy.
  • To analyze the frequency and magnitude of prostate displacements during treatment sessions.
  • To evaluate the temporal dynamics of prostate motion following initial patient positioning.

Main Methods:

  • Utilized the Calypso four-dimensional localization system with electromagnetic markers implanted in the prostate for real-time tracking.

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  • Analyzed 550 continuous tracking sessions across 17 patients.
  • Calculated the fraction of time the prostate was displaced by >3, >5, >7, and >10 mm, and analyzed displacement frequencies over time post-positioning.

    • Main Results:

    • On average, the prostate gland was displaced by >3 mm for 13.6% and >5 mm for 3.3% of the treatment time.
    • Individual patient maximal displacements reached 36.2% (>3 mm) and 10.9% (>5 mm).
    • Prostate displacement >3 mm increased from approximately 12.5% at 5 minutes to 25% at 10 minutes after initial alignment, with individual patient values reaching up to 75%.

    Conclusions:

    • The prostate gland exhibits significant real-time movement during radiotherapy, averaging 14% and 3% displacement over 3 mm and 5 mm, respectively.
    • Individual patient variability in prostate motion is substantial, with displacements up to three times the average.
    • The increasing likelihood of prostate displacement over time post-positioning underscores the importance of initiating radiotherapy promptly after patient setup to minimize treatment inaccuracies.